SURFACTANT

AND ITS ROLE IN

RESPIRATION
Vedansh Tyagi
H 19
MBBS 2020
LEARNING OBJECTIVES
1) What is Surfactant ?
2) Structure of Surfactant Molecule
3) Principle of Surface Tension
4) Effect of Surfactant on Surface Tension
5) Pressure in occluded alveoli caused by Surface Tension
(Laplace’s Law)
6) Clinical Correlation
SURFACTANT
 Surface active agent in water
 Greatly reduces surface tension of water
 Secreted by type II alveolar epithelial cells
 Granular cells, containing lipid inclusions
 Complex mixture of several phospholipids,
proteins, and ions – Dipalmitoyl Phosphatidylcholine
- Surfactant apoproteins
- Calcium ions
 Fatty Acids

Glycerol

Phosphate
Choline
Phosphatidylcholine
Principle of SURFACE TENSION
 When water forms surface with air, water molecules
on surface have strong attraction for each other
 Surface always attempts to contract
 Tends to force the air out of the alveoli
 Causes alveoli to collapse
 Net elastic contractile force called as
Surface tension elastic force
EFFECT OF SURFACTANT ON SURFACE TENSION
 The phospholipids reduce the surface tension
 Do not dissolve uniformly
 Part of molecule dissolves, while remainder spreads
over surface of water
 Reduces surface tension from 1/12 to 1/2
of a pure water surface
 Without surfactant : 50 dynes/cm
 With surfactant : 5-30 dynes/cm
 Significant Reduction
Pressure in occluded alveoli caused by
surface tension
 If air passage blocked,
surface tension tends to collapse alveoli
 Creates Positive Pressure, attempting to push air out
 Amount of Pressure can be calculated by Laplace’s Law :
 Pressure caused by surface tension is inversely related to radius
Half Radius = Double Pressure

 For an average sized alveoli,

Pressure with surfactant : 4 cm H2O
Pressure without surfactant : 18 cm H2O (4.5 times higher)

 Thus, surfactant reduces the effort of respiratory muscles to expand

the lungs
CLINICAL CORRELATION

 Lack of Surfactant
 Excess of Surfactant
LACK OF SURFACTANT
Respiratory Distress Syndrome

 In small immature babies

 Normally begins to be secreted into alveoli between
6th-7th months of gestation
 Premature babies have little to no surfactant when born
 Lungs have extreme tendency to collapse (6-8 times)
 Fatal if not treated with strong measures
EXCESS OF SURFACTANT
Pulmonary Alveolar Proteinosis (PAP)

 Caused by filling of alveoli with large amounts of surfactant

 Gas exchange is greatly hindered
 Symptoms – Labored breathing at rest
- Chest Pain and dry cough
 Lack of ability of pulmonary macrophages to remove surfactant
 Commonly occurs in adults of 30-40 years of age
 It is rarely fatal, if treated
TREATMENTS
1) Respiratory Distress Syndrome
 Nasal Cannula to provide extra oxygen
 Continuous Positive Pressure Breathing using machine
 Surfactant given directly down the breathing
tube into trachea

2) Pulmonary Alveolar Proteinosis

 GM-CSF given Nasal Cannula
SUMMARY
 Surfactant
 Chemical Structure
 Surface Tension
 Effect of surfactant
 Laplace’s Law
 Respiratory Distress Syndrome
 Pulmonary Alveolar Proteinosis
BIBLIOGRAPHY

 Guyton and Hall Textbook of Medical Physiology

 Web References